Surgical appliance.



PATENTEID JULY 21, 1908.

L. G. SGARPA.

SURGICAL APPLIANCE.

LPPLIOATION FILED JUNE 25. 1907.

2 sums-sum 1.

j n nwzaszs No. 894,066. Y PATENTED JULY 21, 1908.

L. G. SOARPA.

SURGICAL APPLIANCE.

APPLICATION FILED JUNE 25, 1907.

2 SHEETS-SHEET 2.

LUIGI GUIDO SGARPA, OF TURIN, ITALY.

SURGICAL APPLIANCE.

Specification of Letters Patent.

Patented July 21, 1908.

Application filed June 25, 1907. Serial No. 380,768.

To all whom it may concern:

Be it known that I, Liner GUIDo SCARPA, a subject of. the King of Italy, residing in Turin, Via della Zecca l 37, physician, have invented certain new and useful Improvements in Surgical Appliances, of which the following is a full, clear, and exact specification My invention is an improvement in surgical apparatus for the treatment ofpulmonary troubles, and consists in certain novel constructions and combination of parts hereinafter described and claimed.

The invention is illustrated in the accompanying drawings, in which Figure 1 is a complete view of the improvement. Fig. 2 is a view of the portion intended for compressing the thorax, the device being in its open position. Fig. 3 is a section on the line a.l of Fig. 2. Fig. 4 is a support S or device for fixing the half 1 which is provided with a pneum atic'oushion in substitution for the half 2 which is illustratedby the drawings. Fig. 5 illustrates the improvement in its open position so that only that portion p p p p is seen, which is intended for the compression of the base of the thorax.

The first of these devices, is substantially composed of two parts:

(a) A sort of half waistcoat 1 corresponding to the one or the other half of the thorax, constructed of an inextensible layer of linen, on the inside of which is a pneumatic cushion p p p p the shape of which corresponds to that of the waist-coat, leaving free only the portion which covers the shoulder, that is to say from the second rib upwards; this pneumatic cushion is constructed of perfectly air-tight material and when filled with air has a thickness of about a centimeter. A small metallic pipe 25 is situated in a certain point of the lower edge of the apparatus in the continuation of the arm-pit region, and is connected with a short indiarubber tube provided with a valve 1 which allows its inflation with an ordinary foot-ball inflater. This lower edge of this half-waistcoat continues with a horizontal band formed of a strong linen strip j, which operates as a girdle surrounding the whole circumference of the body in the epigastric region, from the arch of the ribs to the navel.

This horizontal band has the double result of limiting the movements of the diaphragm downwards by compressing the high portion of the abdominal walls, and of fixing the device in its lower position by means of two continuations r0- vided with buckles x a: which may be tiec between the arch of the ribs and the upper edge of the haunchbone of the opposite side.

(b) A half breast casing 2 formed by four thin vertical plates of nickeled steel or aluminium; two plates on the anterior and two on the posterior side, and are united by means of two other transversal plates which are adapted to the two opposite portions of the thorax; the diameters of this casing are about 6 centimeters larger than the corresponding diameters of the thorax which is under it, so that this may take the greatest possible expansion without being compressed when coming in contact with it. The purpose of this half casing is to provide a point of support in its upper half, that is to say at the level of the shoulder, to the other half of the device, which is provided with the pneumatic cushion, this point of support being formed by a sort of metallic epaulet S of such a form to suit perfectly the .shoulder, and movable by means of a simple device in its vertical and transverse directions to suit different forms and position of the shoulder on different persons. These halves 1 and 2 are united on the middle line of the anterior and posterior side by strings Z Z and small hooks which rigidly connect the two parts, so that the half that is swelled in consequence of the filling of its air cushion, cannot be moved and must remain adherent to the corresponding half of the thorax opposing the dilation movements of the ribs, which are so compelled to remain in their position of extreme expiration, while the epigastric band f completes the result, by limiting the movements of the diaphragm which by way of compensation should tend to increase very much. Instead of the whole thoracic casing 2 and in order to have a more simple and rapid means of fixing the half which is provided with the pneumatic cushion in those cases when the patient is not compelled to remain with his usual dress, a support S may be employed (Fig. 4) that is to say a steel-rod of a U form with-its opening downwards, which is of a convenient form to suit the side of the thorax on which the half casing must be placed. The curved part of the U projects above the corresponding shoulder, and its two vertical prolongations A and B are contained in a vertical plane tangent to the part of the thorax that corres onds to the arm-pit region; A and B extend ownwards to two guides 29 and p on which they are fixed by means of a pair of screw plugs, which are provided on the exterior convex face of a plate L having a length of 20 centimeters, a height of about 4 centimeters and a thickness of 34 millimeters; this plate is slightly concave in the antero-posterior direction of its vertical plane and with its concave surface surrounds and rests on the corresponding side between the ]arch of the ribs and the edge of the haunchone.

By means of the guides of the plate L, the two prolongations A and B of the support (said prolongations being provided with small hooks u a u to which the connection with the half provided with the pneumatic cushion is ossible by means of the strings Z Z 1,) may e slid upwards or downwards in order to lengthen or shorten the support itself to suit the thorax of different persons.

At the level of the shoulder the support is of course provided with the metallic epaulet S which gives the other, that is to say the u per point of support on the shoulder. The distance between the two vertical prolongations A and B, varies from 20 to 30 centimeters according to the development of the thorax to which it is to be adapted. This support may be fixed around the body at the level of the navel by means of straps provided with buckles. The other apparatus shown in Fig. 3, is analogous to the apparatus described above in its functions and its results, that is to say in the immovability that may be obtained of one of the halves of the thorax to the advantage of. the functional activity of the other half, which receives an almost incredible increase in its functional activity. The reason of this consists in the fact well demonstrated and easy to be ascertained that it is possible to separate in the same lungs the functional activity of its upper and lower artso that producing the immovability of the lower or basilary parts of the thorax, a very great augmentation of the functional activity of the upper arts, that is of the su erior lobes of the iiings may be obtaine This apparatus which is shown in Fig. 3 consists of a rectanular band of inextensible lining M N, having a length of 60 to 80 centimeters and a height of 13 to 18 centimeters, in which the shaded rectangle p p p 2) shows the cushion to be filled with air by means of a metallic tube t situated at the base of the left arm-pit region, continuing in an india-rubber tube the end of which is provided with a valve 7". By means of stra s provided with buckles as, 00, the said ban with which the inferior part of thorax is surrounded from the level of the nipple downwards, may be buckled along the middle line of the body s posterior part, and after being filled with air, it gives y necessity of com ensation a very great increase of the activity of the u per half of the thorax which may freely ma e its movements of inhalation and expiration. This apparatus continues downwards with the said epigastric band constructed of resistant lining, which compressing the body between the arch of the ribs and the navel has the result of pressing the epigastric region, limiting the movements of the dia hragm.

The mode of working of oth devices is very easily understood if one considers that by means of the inflation of the pneumatic cushion which is maintained in contact with one of the two thoracic halves or of the basilary part of the whole thorax, in consequence of the inextensibility of the lining which forms the exterior surface, the space which is occupied by the air may be gained only at expense of a depression on the whole part of the thorax which must necessarily take its position of expiration.

What I claim is:

1. Means for immobilizing a ortion of the thorax whereby to increase tide functional activity of the remainder thereof, comprising an inextensible lining, an inflatable cushion on the inner face thereof, a support for the lining on the opposite side of the body and connected therewith, and a band connected with the bottom of the lining for encircling the body of the wearer.

2. Means for immobilizing a portion of the thorax, said means comprising an extensible lining, an inflatable cushion on the inner face thereof, a band connected with the bottom of the lining for encircling the body of the wearer, an open frame for inclosing the opposite side of the body, and a connection between said frame and the lining.

3. Means for immobilizing a portion of the thorax, said means comprising an inextensible lining, an inflatable cushion on the inner face thereof, a band connected with the bottom of the lining for encircling the body of the wearer, an open frame on the opposite side of the body and connected with the lining for supporting the same, and a shoulder-piece for engaging the curve of the shoulder and connected with the frame.

4. Means for immobilizing a portion of the thorax, comprising an inextensible lining, an inflatable cushion on the inner face thereof, a band connected with the bottom of the lining for encircling the body of the wearer,

an open frame on the opposite side of the In witness whereof, Ihave hereunto signed body, a connection between the frame and my name in the presence of two subscribing the lining for supporting said lining, a shoulwitnesses.

der-piece for engaging the curve of the shoul- LUIGI GUIDO SCARPA. 5 der on the opposite side from the lining, and Witnesses:

a connection etween the shoulder-piece and FELIcE BAZETTA,

the frame. LoUrs ALLAN. 

